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https://www.readbyqxmd.com/read/28089815/do-patients-hospitalized-with-copd-have-airflow-obstruction
#1
Huimin Wu, Robert A Wise, Ann E Medinger
BACKGROUND: Guidelines recommend the confirmation of a COPD diagnosis with spirometry. ICD-9-CM diagnostic codes are used frequently to identify patients with COPD for administrative purposes. However, coding the diagnosis of COPD does not require spirometric confirmation. The purpose of this study was to determine how often the discharge diagnoses of COPD is supported by spirometric measurements in the VA health system. METHODS: We reviewed records of patients hospitalized for COPD in a VA teaching hospital between 2005 and 2015...
January 13, 2017: Chest
https://www.readbyqxmd.com/read/28089253/progressive-bilateral-vertebral-artery-dissection-in-a-case-of-osteogenesis-imperfecta
#2
Yuji Kato, Harumitsu Nagoya, Tetsuya Abe, Takeshi Hayashi, Masanori Yasuda, Akira Uchino, Norio Tanahashi, Masaki Takao
A 32-year-old woman with osteogenesis imperfecta (OI) was admitted to the hospital because of a right-sided occipital headache and facial paresthesia. She was diagnosed with lateral medullary syndrome due to right vertebral artery (VA) dissection. She was treated conservatively without antithrombotic therapy. She developed subarachnoid hemorrhage because of contralateral VA dissection 18 days later. This clinical course may reflect the underlying weakness of the vessel wall in OI. In patients with OI, occlusion of a unilateral VA could cause dissection and subsequent rupture of the contralateral VA...
January 11, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28087104/improved-outcomes-from-extracorporeal-membrane-oxygenation-versus-ventricular-assist-device-temporary-support-of-primary-graft-dysfunction-in-heart-transplant
#3
Koji Takeda, Boyangzi Li, Arthur R Garan, Veli K Topkara, Jiho Han, Paolo C Colombo, Maryjane A Farr, Yoshifumi Naka, Hiroo Takayama
BACKGROUND: Primary graft dysfunction (PGD) is one of the most common causes of early death after orthotopic heart transplantation. Mechanical circulatory support devices are required for severe forms of PGD. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) and temporary ventricular assist device (VAD) support have both been reported to be useful for severe PGD. METHODS: Between January 2007 and December 2015, 597 patients received a heart transplant at our center...
December 23, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28074817/extracorporeal-membrane-oxygenation-for-refractory-cardiac-arrest
#4
REVIEW
Steven A Conrad, Peter T Rycus
Extracorporeal cardiopulmonary resuscitation (ECPR) is the use of rapid deployment venoarterial (VA) extracorporeal membrane oxygenation to support systemic circulation and vital organ perfusion in patients in refractory cardiac arrest not responding to conventional cardiopulmonary resuscitation (CPR). Although prospective controlled studies are lacking, observational studies suggest improved outcomes compared with conventional CPR when ECPR is instituted within 30-60 min following cardiac arrest. Adult and pediatric patients with witnessed in-hospital and out-of-hospital cardiac arrest and good quality CPR, failure of at least 15 min of conventional resuscitation, and a potentially reversible cause for arrest are candidates...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28072941/the-expanding-role-of-extracorporeal-membrane-oxygenation-retrieval-services-in-australia
#5
Jjb Edelman, M K Wilson, M P Vallely, P G Bannon, G McKay, S J Robertson, R Hislop, C Wong, B L Cartwright, P Forrest, P J Torzillo
Herein we detail the cases of three patients transferred on veno-arterial extracorporeal membrane oxygenation (VA ECMO) from a tertiary referral hospital to an ECMO centre. We highlight the benefits of such a transfer and offer this as a model of care for unwell patients likely to require a prolonged period of ECMO support.
January 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28057947/pentostatin-cyclophosphamide-and-rituximab-pcr-regimen
#6
Dominic A Solimando, J Aubrey Waddell
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases. Questions or suggestions for topics should be addressed to Dominic A. Solimando, Jr., President, Oncology Pharmacy Services, Inc., 4201 Wilson Blvd #110-545, Arlington, VA 22203, email: OncRxSvc@comcast...
December 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/28057198/comparison-of-poisonings-managed-at-military-and-veterans-administration-hospitals-reported-to-texas-poison-centers
#7
M B Forrester
OBJECTIVES: There is little information on poisonings managed at military and Veterans Administration (VA) hospitals. This investigation described and compared poisonings reported to Texas poison centers that were managed at military and VA hospitals. STUDY DESIGN: Retrospective analysis of poison centre data. METHODS: Cases were poisonings among patients aged 18 years or more reported to Texas poison centers during 2000-2015 where management occurred at a military or VA hospital...
January 2017: Public Health
https://www.readbyqxmd.com/read/28049461/mental-distress-following-inpatient-substance-use-treatment-modified-by-substance-use-comparing-voluntary-and-compulsory-admissions
#8
Adrian R Pasareanu, John-Kåre Vederhus, Anne Opsal, Øistein Kristensen, Thomas Clausen
BACKGROUND: Treatment services to patients with substance use disorders (SUDs), including those mandated to treatment, needs to be evaluated and evidence based. The Norwegian Municipal Health Care Act (NMHCA) calls for compulsory treatment for persons with "severe and life-threatening substance use disorder" if these individuals are not otherwise willing to be voluntarily treated and consequently risk their lives over drug use. Mental distress is known to be high among SUD patients admitted to inpatient treatment...
January 3, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28046080/the-annual-burden-of-seasonal-influenza-in-the-us-veterans-affairs-population
#9
Yinong Young-Xu, Robertus van Aalst, Ellyn Russo, Jason K H Lee, Ayman Chit
Seasonal influenza epidemics have a substantial public health and economic burden in the United States (US). On average, over 200,000 people are hospitalized and an estimated 23,000 people die from respiratory and circulatory complications associated with seasonal influenza virus infections each year. Annual direct medical costs and indirect productivity costs across the US have been found to average respectively at $10.4 billion and $16.3 billion. The objective of this study was to estimate the economic impact of severe influenza-induced illness on the US Veterans Affairs population...
2017: PloS One
https://www.readbyqxmd.com/read/28027338/effect-of-an-intensive-outpatient-program-to-augment-primary-care-for-high-need-veterans-affairs-patients-a-randomized-clinical-trial
#10
Donna M Zulman, Christine Pal Chee, Stephen C Ezeji-Okoye, Jonathan G Shaw, Tyson H Holmes, James S Kahn, Steven M Asch
Importance: Many organizations are adopting intensive outpatient care programs for high-need patients, yet little is known about their effectiveness in integrated systems with established patient-centered medical homes. Objective: To evaluate how augmenting the Veterans Affairs (VA) medical home (Patient Aligned Care Teams [PACT]) with an Intensive Management program (ImPACT) influences high-need patients' costs, health care utilization, and experience. Design, Setting, and Participants: Randomized clinical trial at a single VA facility...
December 27, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28018534/does-psychological-safety-impact-the-clinical-learning-environment-for-resident-physicians-results-from-the-va-s-learners-perceptions-survey
#11
Karina D Torralba, Lawrence K Loo, John M Byrne, Samuel Baz, Grant W Cannon, Sheri A Keitz, Annie B Wicker, Steven S Henley, T Michael Kashner
BACKGROUND : Psychological safety (PS) is the perception that it is safe to take interpersonal risks in the work environment. In teaching hospitals, PS may influence the clinical learning environment for trainees. OBJECTIVE : We assessed whether resident physicians believe they are psychologically safe, and if PS is associated with how they rate satisfaction with their clinical learning experience. METHODS : Data were extracted from the Learners' Perceptions Survey (LPS) of residents who rotated through a Department of Veterans Affairs health care facility for academic years 2011-2014...
December 2016: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28004297/evaluation-of-the-first-fracture-liaison-service-in-the-greek-healthcare-setting
#12
Polyzois Makras, Maria Panagoulia, Andriana Mari, Stavroula Rizou, George P Lyritis
: We evaluated the first implementation of FLS in the Greek healthcare setting, at the 251 Hellenic Air Force and VA General Hospital of Athens. Participation rate was moderate (54.5%) and needs improvement; osteoporosis medication was either suggested or reviewed in 74 out of the 116 patients recruited. PURPOSE: The purpose of this study was to evaluate the first implementation of a fracture liaison service (FLS) in Greece, at the 251 Hellenic Air Force and VA General Hospital, Athens...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28003177/substitution-of-usual-perioperative-care-by-ehealth-to-enhance-postoperative-recovery-in-patients-undergoing-general-surgical-or-gynecological-procedures-study-protocol-of-a-randomized-controlled-trial
#13
Eva van der Meij, Judith Af Huirne, Esther Va Bouwsma, Johanna M van Dongen, Caroline B Terwee, Peter M van de Ven, Chantal M den Bakker, Suzan van der Meij, W Marchien van Baal, Wouter Kg Leclercq, Peggy Maj Geomini, Esther Cj Consten, Steven E Schraffordt Koops, Paul Jm van Kesteren, Hein Bac Stockmann, A Dorien Ten Cate, Paul Hp Davids, Petrus C Scholten, Baukje van den Heuvel, Frederieke G Schaafsma, Wilhelmus Jhj Meijerink, H Jaap Bonjer, Johannes R Anema
BACKGROUND: Due to the strong reduction in the length of hospital stays in the last decade, the period of in-hospital postoperative care is limited. After discharge from the hospital, guidance and monitoring on recovery and resumption of (work) activities are usually not provided. As a consequence, return to normal activities and work after surgery is hampered, leading to a lower quality of life and higher costs due to productivity loss and increased health care consumption. OBJECTIVE: With this study we aim to evaluate whether an eHealth care program can improve perioperative health care in patients undergoing commonly applied abdominal surgical procedures, leading to accelerated recovery and to a reduction in costs in comparison to usual care...
December 21, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/28001123/fine-scale-spatial-and-temporal-variation-in-temperature-and-arrhythmia-episodes-in-the-va-normative-aging-study
#14
Antonella Zanobetti, Brent A Coull, Itai Kloog, David Sparrow, Pantel S Vokonas, Diane R Gold, Joel Schwartz
: Many studies have demonstrated that cold and hot temperatures are associated with increased deaths and hospitalization rates; new findings indicate also an association with more specific cardiac risk factors. Most of these existing studies have relied on few weather stations to characterize exposures; few have used residence-specific estimates of temperature, or examined the exposure-response function. We investigated the association of arrhythmia episodes with spatial and temporal variation in temperature...
January 2017: Journal of the Air & Waste Management Association
https://www.readbyqxmd.com/read/27999253/treatment-of-post-traumatic-stress-disorder-nightmares-at-a-veterans-affairs-medical-center
#15
Mark B Detweiler, Bhuvaneshwar Pagadala, Joseph Candelario, Jennifer S Boyle, Jonna G Detweiler, Brian W Lutgens
The effectiveness of medications for PTSD in general has been well studied, but the effectiveness of medicatio.ns prescribed specifically for post-traumatic stress disorder (PTSD) nightmares is less well known. This retrospective chart review examined the efficacy of various medications used in actual treatment of PTSD nightmares at one Veteran Affairs Hospital. Records at the Salem, VA Veterans Affairs Medical Center (VAMC) were examined from 2009 to 2013 to check for the efficacy of actual treatments used in comparis...
December 16, 2016: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/27994255/review-of-venoarterial-extracorporeal-membrane-oxygenation-and-development-of-intracardiac-thrombosis-in-adult-cardiothoracic-patients
#16
REVIEW
Brittney Williams, Wendy Bernstein
Venoarterial extracorporeal membrane oxygenation (VA ECMO) has become an indispensable treatment option for adult cardiothoracic patients experiencing acute refractory cardiogenic shock. VA ECMO is not without inherent complications as in-hospital mortality has ranged from 45% to 65% (1-3). Intracardiac thrombosis (ICT) is a rare but life-threatening complication associated with VA ECMO. VA ECMO cases complicated by ICT were searched for using the MEDLINE (PubMed and OVID), Society of Cardiovascular Anesthesiology Headquarters, and Google Scholar databases...
December 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27990036/probabilistic-cause-of-death-assignment-using-verbal-autopsies
#17
Tyler H McCormick, Zehang Richard Li, Clara Calvert, Amelia C Crampin, Kathleen Kahn, Samuel J Clark
In regions without complete-coverage civil registration and vital statistics systems there is uncertainty about even the most basic demographic indicators. In such regions the majority of deaths occur outside hospitals and are not recorded. Worldwide, fewer than one-third of deaths are assigned a cause, with the least information available from the most impoverished nations. In populations like this, verbal autopsy (VA) is a commonly used tool to assess cause of death and estimate cause-specific mortality rates and the distribution of deaths by cause...
2016: Journal of the American Statistical Association
https://www.readbyqxmd.com/read/27989423/-diagnostic-and-therapeutic-contribution-of-microbiological-analysis-in-severe-microbial-keratitis-at-reims-university-hospital-between-2012%C3%A2-and-2014
#18
J Caliot, D Guindolet, A Ducasse, L Andreoletti, C Arndt
PURPOSE: To investigate the contribution of microbial analysis in the diagnosis and management of severe microbial keratitis. MATERIAL AND METHOD: This is a monocentric retrospective study at the University Hospital of Reims from January 2012 to December 2014. Corneal scrapings with infectious keratitis were subjected to routine bacterial and fungal culture. PCR was also performed to detect various viral DNA (VZV, CMV, EBV, HSV 1 & 2, adenovirus) and Acanthamoeba sp...
December 15, 2016: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/27983865/suicide-risk-management-protocol-in-post-cardiac-arrest-survivors-development-feasibility-and-outcomes
#19
Rachel A Bucy, Kaitlyn A Hanisko, Lee A Kamphuis, Brahmajee K Nallamothu, Theodore J Iwashyna, Paul N Pfeiffer
RATIONALE: Suicidal ideation is an important part of the spectrum of depression, but studies of outcomes following cardiac events often avoid asking about suicide as part of their assessment due to perceived resource constraints and the complexity of managing this finding. OBJECTIVES: To describe the development, feasibility, and outcomes of a suicide risk management protocol implemented by research assistants (RAs) administering the Patient Health Questionnaire Depression Scale (PHQ-9)...
December 16, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27981530/relationship-between-deficiencies-in-vitamin-a-and-e-and-occurrence-of-infectious-diseases-among-children
#20
Y-J Qi, Q-L Niu, X-L Zhu, X-Z Zhao, W-W Yang, X-J Wang
OBJECTIVE: To investigate the relationship between vitamin A deficiency (VAD), vitamin E deficiency (VED) and infectious diseases. PATIENTS AND METHODS: We chose 684 cases of healthy children age 5 months-12 years from our hospital, measured their VA, VE from vein under the light proof condition with high-pressure liquid chromatography. Thereafter, the children who get the acute respiratory tract infection (ARI) or diarrhea two weeks later were registered. RESULTS: After the two weeks trial (N=684 cases), the VA level of children with ARI was lower than that of children without ARI (0...
December 2016: European Review for Medical and Pharmacological Sciences
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